Plain-language definition
The Medicare Change of Status Notice, or MCSN, is the standardized hospital notice used for certain Original Medicare patients who were formally admitted as inpatients and then reclassified as outpatients receiving observation services.
What it tells the patient
The notice identifies the status change, explains how it may affect hospital charges and later skilled nursing facility coverage, and gives instructions for requesting BFCC-QIO review. It is also identified by the form number CMS-10868.
Who receives it
The notice is not required for every outpatient observation stay. The fast appeal applies when the person meets the federal eligibility conditions, including the original inpatient admission, later reclassification, and either lack of Part B during the hospitalization or a stay of at least three consecutive days with fewer than three inpatient days under the SNF counting rule.
When it is delivered
The hospital must give the MCSN as soon as possible after the conditions are met and no later than four hours before release. An eligible beneficiary who wants the special expedited process must contact the BFCC-QIO before release.
How it differs from a MOON
The Medicare Outpatient Observation Notice (MOON), CMS-10611, explains that a person is an outpatient receiving observation services and describes the effects of that status. The MCSN specifically addresses a hospital's change from inpatient to outpatient observation and the appeal right for an eligible Original Medicare beneficiary.
How it differs from the Important Message from Medicare
The Important Message from Medicare explains inpatient hospital discharge rights and the fast appeal when a patient believes discharge is too soon. The MCSN concerns whether the hospital's change in patient classification was correct for Medicare Part A payment.
Practical example
A patient is formally admitted on Monday. The hospital later changes the patient to outpatient observation and determines that the federal appeal conditions apply. Before release, the hospital gives CMS-10868 with the BFCC-QIO contact information. The patient calls that reviewer to request an expedited status determination.
Official sources
- CMS — Medicare Change of Status Notice
- CMS — Beneficiary Notices Initiative
- eCFR — MCSN requirements
- Medicare.gov — patient-status appeals